RESUMO
Optical coherence tomography (OCT) is one of the most important imaging modalities for biophotonics applications. In this work, an important step towards the clinical use of OCT in dental practice is reported, by following-up patients treated from periodontal disease (PD). A total of 147 vestibular dental sites from 14 patients diagnosed with PD were evaluated prior and after treatment, using a swept-source OCT and two periodontal probes (Florida probe and North Carolina) for comparison. The evaluation was performed at four stages: day 0, day 30, day 60 and day 90. Exceptionally one patient was evaluated 1-year after treatment. It was possible to visualize in the two-dimensional images the architectural components that compose the periodontal anatomy, and identify the improvements in biofilm and dental calculus upon treatment. In the follow-up after the treatment, it was observed in some cases decrease of the gingival thickness associated with extinction of gingival calculus. In some cases, the improvement of both depth of probing with the traditional probes and the evidence in the images of the region was emphasized. The study evidenced the ability of OCT in the identification of periodontal structures and alterations, being an important noninvasive complement or even alternative for periodontal probes for treatment follow-up. OCT system being used in a clinical environment. Above OCT image (left) prior treatment and (right) 30 days after treatment.
Assuntos
Doenças Periodontais/diagnóstico por imagem , Doenças Periodontais/terapia , Tomografia de Coerência Óptica , Progressão da Doença , Seguimentos , Humanos , Doenças Periodontais/patologiaRESUMO
BACKGROUND: Periodontitis is a multifactorial and infectious disease that may result in significant debilitation. The aim of this study is to exploit two optical coherence tomography (OCT) systems operating in the Fourier domain at different wavelengths, 930 and 1,325 nm, for structural analysis of periodontal tissue in porcine jaws. METHODS: Five fresh porcine jaws were sectioned and stored in formalin before OCT analysis. Two- and three-dimensional OCT images of the tooth/gingiva interface were performed, and measurements of the gingival structures were obtained. The 930-nm OCT system operates in the spectral domain, whereas the 1,325-nm system is a swept-source model. Stereomicroscope images, the gold standard, were used for direct comparison. RESULTS: Through image analysis, it is possible to identify the free gingiva and the attached gingiva, the calculus deposition over tooth surfaces, and the subgingival calculus that enables the enlargement of the gingival sulcus. In addition, the gingival thickness and the gingival sulcus depth can be non-invasively measured, varying from 0.8 to 4 mm. CONCLUSIONS: Regarding the ability of the two OCT systems to visualize periodontal structures, the system operating at 1,325 nm shows a better performance, owing to a longer central wavelength that allows deeper tissue penetration. The results with the system at 930 nm can also be used, but some features could not be observed due to its lower penetration depth in the tissue.